Ren Jiayi, Chen Jinxiang, Zhang Kexin, Wang Yuqun, Zhang Xiaofei, Xiong Guoji, Sun Xiaodong, Hou Ningning, Kan Chengxia
Department of Endocrinology and Metabolism, Shandong Provincial Key Medical and Health Laboratory of Endocrinology and Endocrinology Diseases, Affiliated Hospital of Shandong Second Medical University, Weifang, China.
Clinical Research Center, Affiliated Hospital of Shandong Second Medical University, Weifang, China.
Hormones (Athens). 2025 Jun 20. doi: 10.1007/s42000-025-00685-9.
Obesity, particularly visceral adiposity, is linked to altered thyroid function; the underlying mechanisms, however, remain unclear. This study examines the associations between the visceral adiposity index (VAI), lipid accumulation product (LAP), and thyroid function in U.S. adults.
This cross-sectional study used National Health and Nutrition Examination Survey (NHANES) data (2007-2012), including 3,170 participants after exclusions. Thyroid function parameters, VAI, and LAP were analyzed. Covariates included demographics, lifestyle, clinical factors, multiple linear regression, and restricted cubic splines, while generalized additive models were employed to assess linear and nonlinear relationships.
VAI and LAP were significantly associated with thyroid function parameters. VAI positively correlated with total triiodothyronine [β = 0.79, 95% confidence interval (CI) = 0.37 to 1.21, P < 0.001] and antithyroglobulin antibodies (β = 1.81, 95% CI = 0.19 to 3.43, P = 0.028) after adjusting for confounders. LAP demonstrated significant positive associations with total triiodothyronine, thyroid-stimulating hormone (TSH), and thyroid sensitivity indices (e.g., TSH index and thyroxine resistance index) but correlated negatively with free thyroxine. Nonlinear relationships were identified, with higher VAI linked to rapid increases in total triiodothyronine and antithyroglobulin antibodies, plateauing at specific thresholds. Elevated LAP was associated with increased thyroid peroxidase antibodies, suggesting a link with thyroid autoimmunity.
VAI and LAP are strongly associated with thyroid dysfunction, with implications for thyroid sensitivity and autoimmunity. These findings underscore the importance of addressing visceral adiposity and metabolic dysregulation to mitigate thyroid-related disorders. Future studies are warranted to explore causal mechanisms and intervention strategies.
肥胖,尤其是内脏脂肪过多,与甲状腺功能改变有关;然而,其潜在机制仍不清楚。本研究调查了美国成年人内脏脂肪指数(VAI)、脂质蓄积产物(LAP)与甲状腺功能之间的关联。
这项横断面研究使用了国家健康和营养检查调查(NHANES)(2007 - 2012年)的数据,排除后包括3170名参与者。分析了甲状腺功能参数、VAI和LAP。协变量包括人口统计学、生活方式、临床因素、多元线性回归和受限立方样条,同时采用广义相加模型评估线性和非线性关系。
VAI和LAP与甲状腺功能参数显著相关。调整混杂因素后,VAI与总三碘甲状腺原氨酸呈正相关[β = 0.79,95%置信区间(CI)= 0.37至1.21,P < 0.001],与抗甲状腺球蛋白抗体呈正相关(β = 1.81,95% CI = 0.19至3.43,P = 0.028)。LAP与总三碘甲状腺原氨酸、促甲状腺激素(TSH)和甲状腺敏感性指数(如TSH指数和甲状腺素抵抗指数)呈显著正相关,但与游离甲状腺素呈负相关。发现了非线性关系,较高的VAI与总三碘甲状腺原氨酸和抗甲状腺球蛋白抗体的快速增加有关,在特定阈值时趋于平稳。LAP升高与甲状腺过氧化物酶抗体增加有关,提示与甲状腺自身免疫有关。
VAI和LAP与甲状腺功能障碍密切相关,对甲状腺敏感性和自身免疫有影响。这些发现强调了处理内脏脂肪过多和代谢失调以减轻甲状腺相关疾病的重要性。未来的研究有必要探索因果机制和干预策略。